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Dental and Oral Health Center

Toothache and root canal

05/14/2007

Question:

I have a painful toothache from 2 teeth that are already dead. I had a root canal 20 years ago with one and 10 years ago with the other. I began to feel a little discomfort with them 5 days ago and on the second day I began to feel sick. I feel like I have the flu, but the toothache is getting worse. I don`t know why my teeth hurt so bad since both are dead.

I thought I had grinded my teeth the night before causing the discomfort, but now the pain is almost unbearable. There is no swelling that I can see, no food or holes in either tooth. One of the teeth is fake (put into the root with a post) and the other is only half fake (broken in half and had a root canal before getting a crown). So what could be the cause of my pain? Why do I feel like I`ve got the flu?

Answer:

This could be a case of re-infection of the root canal. The symptoms you are describing are very characteristic of an active infectious process. Even though the tooth has been treated with a root canal, there could exist a microscopic leakage through the crown with saliva and bacteria.

This situation could dissolve the sealer that attaches the crown to the tooth and also the sealer of the root canal itself. Thus, the passage of bacteria again to the canal area would create an infection, similar to what happens when the nerve of a tooth gets infected. The tooth can be re-treated with a root canal if possible. Sometimes there will be many existing variables that will not allow for the re-treatment to be highly successful.

Hence, extraction of the tooth in question might be necessary. An infection that presents flu-like symptoms should be considered seriously, and the treatment of the infected tooth should be done ASAP in conjunction with antibiotic therapy. Antibiotics alone will not cure the infection source.

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Response by:

Jose I Arauz-Dutari, DMD Jose I Arauz-Dutari, DMD
Formerly, Assistant Professor of Periodontics
School of Dental Medicine
Case Western Reserve University